Is anyone treating those AIDS-circumcision studies seriously enough to get one?

Question

I think it's ridiculous. Why not chop off the entire thing to prevent STDs altogether?

Answer 1

"As far as I can tell, nobody asked the men how often they had sex and how many partners they had,"

"All participants were closely followed for two years to collect information about their health, sexual activity, and theirs and their partners’ attitudes about circumcision; to counsel participants in HIV prevention and safe sex practices; and to check the HIV status of the volunteer." (see source 1)

"so my guess is that circumcision cut way down on all types of sexual activity"

We won't know until these studies are published, but the first RCT reported the opposite: "Of the five reported sexual behavioural factors, all were higher in the intervention group than in the control group during the period M4–M12, and four out of five were higher during the period M13–M21." (see 2)

"(because it cut down on pleasure)."

I suggest you read source 3.

Answer 2

NIH backs circumcision in AIDS fight
Procedure an effective way to stop HIV, says National Institutes of Health
By Robert Bazell
Chief science and health correspondent
NBC News
Updated: 6:10 p.m. ET Dec. 13, 2006
Circumcising adult men is an effective way to limit transmission of the virus that causes AIDS. The National Institutes of Health announced today that two clinical trials in Africa have been stopped because an independent monitoring board determined the treatment was so effective that it would be unethical to continue the experiment.

"We now have confirmation — from large, carefully controlled, randomized clinical trials —showing definitively that medically performed circumcision can significantly lower the risk of adult males contracting HIV through heterosexual intercourse," said Dr. Anthony Fauci, director of the National Institute of Allergy and Infectious Disease. "While the initial benefit will be fewer HIV infections in men, ultimately adult male circumcision could lead to fewer infections in women in those areas of the world where HIV is spread primarily through heterosexual intercourse."

The NIH has been sponsoring two trials — one with 5,000 men, ages 15 to 49, in Uganda and a second with 2,784 men, 18-24, in Kenya. Half the men voluntarily underwent circumcision. The men were then monitored for about two years. Far more of the uncircumcised men became infected with HIV.

The studies found that the circumcised men in the Kenyan study were 48 percent less likely to get infected and 53 percent less likely in the Ugandan study.


This finding appears to apply only to heterosexual transmission, which is the main mode of spread in Africa.

Male circumcision is common at birth in the United States. But in sub-Saharan Africa, home to more than half of the world’s almost 40 million HIV-infected people, there are large swaths of populations where male circumcision is rare.

Circumcision is not perfect protection, Fauci stressed. Men who become circumcised must not quit using condoms nor take other risks — and circumcision offers no protection from HIV acquired through anal sex or injection drug use, he noted.

“It’s not a magic bullet, but a potentially important intervention,” agreed Dr. Kevin De Cock of the World Health Organization.

These findings present enormous ethical and policy decisions which have yet to be addressed. But scientists say the reduction of infection is so substantial that the findings cannot be ignored.

© 2006 MSNBC Interactive© 2006 MSNBC InteractiveThe Associated Press contributed to this report.
URL: http://www.msnbc.msn.com/id/16184582/

Answer 3

As far as I can tell, nobody asked the men how often they had sex and how many partners they had, so my guess is that circumcision cut way down on all types of sexual activity (because it cut down on pleasure).

In Africa, where these studies were done, condoms are expensive, hard to find, and culturally unacceptable. The study has little relevance to other areas of the world where they are cheap, abundant, and acceptable to most men. HIV is actually more common in the US, where most sexually-active men have been cut, than in Europe, with a sexually intact male population, probably because needle-sharing is more common in the US, so why not try to prevent needle-sharing instead of sexually mutilating men who are at low risk..

Answer 4

Your point of view is ridiculous and irresponsible.

Circumcision can save over two million in the next 15 years. This is very serious and should not be taken as a joke.

All these studies have been carried out by prestigious and respectable research institutions and universities, and are backed in many cases by official organisations such as the US National Institutions of Health or the World Health Organisation.

Circumcision rates are increasing nowadays, both in the United States and overseas. Many African and South American countries with little circumcision tradition are starting to promote the procedure to help to reduce the AIDS-HIV infection rates.

The sites below have very interesting information related to this topic. Please have a look.

Answer 5

I think the benefit is obvious. Ask the Africans who are lining up to have it done.
Circumcision Halves H.I.V. Risk, U.S. Agency Finds

By DONALD G. McNEIL Jr. New York Times
Published: December 14, 2006
Circumcision appears to reduce a man’s risk of contracting AIDS from heterosexual sex by half, United States government health officials said yesterday, and the directors of the two largest funds for fighting the disease said they would consider paying for circumcisions in high-risk countries.

Q&A About the NIAID-Sponsored Adult Male Circumcision Trials in Kenya and Uganda (National Institute of Allergy and Infectious Diseases)
The announcement was made by officials of the National Institutes of Health as they halted two clinical trials, in Kenya and Uganda, on the ground that not offering circumcision to all the men taking part would be unethical. The success of the trials confirmed a study done last year in South Africa.

AIDS experts immediately hailed the finding. “This is very exciting news,” said Daniel Halperin, an H.I.V. specialist at the Harvard Center for Population and Development, who has argued that circumcision slows the spread of AIDS in the parts of Africa where it is common.

In an interview from Zimbabwe, he added, “I have no doubt that as word of this gets around, millions of African men will want to get circumcised, and that will save many lives.”

Uncircumcised men are thought to be more susceptible because the underside of the foreskin is rich in Langerhans cells, sentinel cells of the immune system, which attach easily to the human immunodeficiency virus, which causes AIDS. The foreskin also often suffers small tears during intercourse.

But experts also cautioned that circumcision is no cure-all. It only lessens the chances that a man will catch the virus; it is expensive compared to condoms, abstinence or other methods; and the surgery has serious risks if performed by folk healers using dirty blades, as often happens in rural Africa.

Circumcision is “not a magic bullet, but a potentially important intervention,” said Dr. Kevin M. De Cock, director of H.I.V./AIDS for the World Health Organization.

Sex education messages for young men need to make it clear that “this does not mean that you have an absolute protection,” said Dr. Anthony S. Fauci, an AIDS researcher and director of the National Institute of Allergy and Infectious Diseases.

Circumcision should be used with other prevention methods, he said, and it does nothing to prevent spread by anal sex or drug injection, ways in which the virus commonly spreads in the United States.

The two trials, conducted by researchers from universities in Illinois, Maryland, Canada, Uganda and Kenya, involved nearly 3,000 heterosexual men in Kisumu, Kenya, and nearly 5,000 in Rakai, Uganda. None were infected with H.I.V. They were divided into circumcised and uncircumcised groups, given safe sex advice (although many presumably did not take it), and retested regularly.

The trials were stopped this week by the N.I.H. Data Safety and Monitoring Board after data showed that the Kenyan men had a 53 percent reduction in new H.I.V. infection. Twenty-two of the 1,393 circumcised men in that study caught the disease, compared with 47 of the 1,391 uncircumcised men.

In Uganda, the reduction was 48 percent.

Those results echo the finding of a trial completed last year in Orange Farm, a township in South Africa, financed by the French government, which demonstrated a reduction of 60 percent among circumcised men.

The two largest agencies dedicated to fighting AIDS said they would now be willing to pay for circumcisions, which they have not before because there was too little evidence that it worked.

Dr. Richard G. A. Feachem, executive director of the Global Fund to Fight AIDS, Tuberculosis and Malaria, which has almost $5 billion in pledges, said in a television interview that if a country submitted plans to conduct sterile circumcisions, “I think it’s very likely that our technical panel would approve it.”

Dr. Mark Dybul, executive director of President Bush’s $15 billion Emergency Plan for AIDS Relief, said in a statement that his agency “will support implementation of safe medical male circumcision for H.I.V./AIDS prevention” if world health agencies recommend it.

He also warned that it was only one new weapon in the fight, adding, “Prevention efforts must reinforce the A.B.C. approach — abstain, be faithful, and correct and consistent use of condoms.”

Researchers have long noted that parts of Africa where circumcision is common — particularly the Muslim countries of West Africa — have much lower AIDS rates, while those in southern Africa, where circumcision is rare, have the highest.

But drawing conclusions was always confounded by other regional factors, like strict Shariah law in some Muslim areas, rape and genocide in East Africa, polygamy, rites that require widows to have sex with a relative, patronage of prostitutes by miners, and men’s insistence on dangerous “dry sex” — with the woman’s vaginal walls robbed of secretions with desiccating herbs.

Outside Muslim regions, circumcision is spotty. In South Africa, for example, the Xhosa people circumcise teenage boys, while Zulus do not. AIDS is common in both tribes.

Nelson Mandela’s autobiography, “Long Walk to Freedom,” contains an unnerving but hilarious account of his own Xhosa circumcision, by spear blade, as a teenager. Although he was supposed to shout, “I am a man!” he grimaced in pain, he wrote.

But not all initiation ceremonies are laughing matters. Every year, some South African teenagers die from infections, and the use of one blade on many young men may help spread AIDS.

In recent years, as word has spread that circumcision might be protective, many southern African men have sought it out. A Zambian hospital offered $3 circumcisions last year, and Swaziland trained 60 doctors to do them for $40 after waiting lists at its national hospital grew.

“Private practitioners also do it,” Dr. Halperin said. “In some places, it’s $20; in others, much more. Lots of the wealthy elite have already done it. It prevents S.T.D.’s, it’s seen as cleaner, sex is better, women like it. I predict that a lot of men who can’t afford private clinics will start clamoring for it.” (S.T.D.’s are sexually transmitted diseases.)

Male circumcision also benefits women. For example, a study of the medical records of 300 Ugandan couples last year estimated that circumcised men infected with H.I.V. were about 30 percent less likely to transmit it to their female partners.

Earlier studies on Western men have shown that circumcision significantly reduces the rate at which men infect women with the virus that causes cervical cancer. A study published in 2002 in The New England Journal of Medicine found that uncircumcised men were about three times as likely as circumcised ones with a similar number of sexual partners to carry the human papillomavirus.

The suspected mechanism was the same — cells on the inside of the foreskin were also more susceptible to that virus, which is not closely related to H.I.V.